Reasons for Discontinuation of Intravitreal Vascular Endothelial Growth Factor Inhibitors in Neovascular Age-Related Macular Degeneration

In Brief Background: This study was aimed to identify the reasons for discontinuing intravitreal anti-vascular endothelial growth factor therapy in neovascular age-related macular degeneration. Methods: This study is a retrospective chart review of a single Australian private practice. Analysis included patients who discontinued treatment from March 2006 to June 2012. Results: Of 248 patients who commenced treatment, 105 (42.3%) had discontinued by June 2012. The reasons for discontinuation were available for 102 of the 105 (97.1%) patients. In 9 (3.6%) patients of the entire cohort, the doctor stopped the treatment as the lesion became inactive, whereas further treatment was thought to be futile in 27 (10.9%) patients. Twenty-six (10.5%) patients declined further treatment with 2 (0.8%) because of excessive treatment visits, 2 (0.8%) because of difficulty in attending, 2 (0.8%) because of the expense, 3 (1.2%) because of pain/discomfort, 6 (2.4%) thought that the treatment was not beneficial, and 11 (4.4%) had other medical conditions that were more severe. Treatment was discontinued in 40 (16.1%) patients for other reasons such as moving to another region in 27 (10.9%) and death in 11 (4.4%). Conclusion: These results indicate that the burden of intravitreal anti-vascular endothelial growth factor injections was a reason for treatment discontinuation in only a small minority of patients. This study was aimed at identifying the reasons for discontinuation of intravitreal anti-vascular endothelial growth factor therapy in neovascular age-related macular degeneration. The burden of ongoing treatment was a reason for discontinuation in only a small minority of patients. Many patients who lost vision eventually gave up treatment; however, it was the doctor rather than the patient who usually made this decision.